Antidepressants are a crucial part of mental health treatment for many people, including those who are pregnant. However, their use during pregnancy raises important questions about potential risks to foetal development.

Types of Antidepressants and Their Use in Pregnancy

General Risks Associated with Antidepressant Use in Pregnancy

Preterm Birth and Low Birth Weight: Some studies link antidepressant use, especially SSRIs, with an increased risk of preterm birth and low birth weight, although these findings are often complicated by the severity of maternal depression. Severe depression during pregnancy is associated with adverse outcomes such as preterm birth, low birth weight, and developmental delays.

Cognitive and Behavioural Development: Research shows mixed results. Some studies report no significant long-term impact, while others suggest potential risks for developmental issues.

Motor Development: Potential delays have been observed, but findings are inconsistent and often confounded by underlying maternal depression.

Specific Findings by Antidepressant Class

SSRIs

SSRIs are the most studied class with mixed outcomes. While some studies indicate an increased risk, others find no significant long-term developmental impacts.

However, an increased risk of Persistent Pulmonary Hypertension of the Newborn (PPHN), has been observed with late-pregnancy SSRI exposure.

Some studies have suggested an association between first-trimester use of SSRIs (e.g., paroxetine and fluoxetine) and an increased risk of congenital heart defects. However, the absolute risk increase is small.

SNRIs

Although SNRIs are less studied, there are potential risks similar to SSRIs, including preterm birth and neonatal adaptation syndrome.

TCAs and MAOIs

These are less commonly prescribed due to side effect profiles, but studies indicate potential risks of neonatal withdrawal and cognitive impacts.

Clinical Recommendations and Risk Mitigation

Decisions should be tailored to the individual's mental health needs, considering the risks and benefits of continuing or discontinuing medication.

For those seeking more detailed information or guidance, consulting with a healthcare professional specialising in maternal-foetal medicine or psychiatry is vital.